Measurement of fluid volume shifts during hemodialysis by A-mode ultrasonography

Background: The rate of intercompartmental fluid volume changes during hemo dialysis (HD) is a major determinant of dialysis-induced hypotension and la cks direct monitoring, The aim of the study was to evaluate the feasibility of tissue thickness (TT) measurement in monitoring the mobilization of int erstitial fluids during HD, Methods: We studied the intradialytic changes i n forehead TT and inferior vena cava diameter (IVCD) in 20 patients. Plasma refilling was calculated from changes in hematocrit (Hct) and ultrafiltrat ion rates, Results: During ultrafiltration of 2,437 +/- 117 mi (mean +/- SE M), Hct increased significantly from 27.9 +/- 0.7 to 30.0 +/- 0.9%. IVCD de creased significantly from 9.7 +/- 0.2 to 6.1 +/- 0.4 mm/m(2). We found a s imultaneously pronounced reduction in rr from 4.46 +/- 0.12 to 3.78 +/- 0.1 2 mm (greater than or equal to 15.3%) with a significant correlation to pla sma refilling (0.613), Conclusion: Volume changes in the peripheral shell t issues during HD can be monitored directly and noninvasively by A-mode ultr asound. Copyright (C) 2000 S. Karger AG, Basel.